Nurse Case Manager Loyal Source Government Services LLCNurse Case ManagerHomestead, FLThe Case Manager shall collect, organize, record, and communicate data relevant to primary health assessments including a detailed medical history in order to develop time sensitive treatment plans which delineate the expected process of care delivery for selected case managed patients or populations. The Nurse Case Manager, hereafter referred to as the Case Manager, shall provide a full range of professional health nursing principles, practices, and procedures in clinical settings in order to analyze the full scope of problems associated with providing appropriate, cost effective care to Department of Defense (DOD) beneficiaries.
Telephonic RN Nurse Case Manager I - AmeriBen Elevance Health IncTelephonic RN Nurse Case Manager I - AmeriBenMiami, FL$63,840–$100,800 / yearThe Telephonic Nurse Case Manager I is responsible for performing care management within the scope of licensure for members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
Case Manager - Registered Nurse CVS Health CorpCase Manager - Registered NurseFL$66,575–$142,576 / yearImplements and coordinates all case management activities relating to catastrophic cases and chronically ill members/clients across the continuum of care that can include consultant referrals, home care visits, the use of community resources, and alternative levels of care. Community Care Case Manager use a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet an individual's comprehensive health needs through communication and available resources to promote quality, cost effective outcomes.
NewTravel RN-Case Manager in Davie, Florida Voyage HealthTravel RN-Case Manager in Davie, FloridaDavie, FL$2,005–$2,110At Voyage Healthcare, we help connect nurses, therapists, and allied health pros with high-paying travel jobs at top-rated facilities across the U.S. With thousands of openings nationwide, you can earn up to $3,500+ per week (depending on your specialty, location, housing, and benefits)—all while making a real impact on the communities that need you most. We're hiring experienced RN-Case Manager for a 13-week contract in Davie, Florida — earn up to ($2005 - $2111 per week) while providing essential care at a leading facility.
Case Manager (H) University of MiamiCase Manager (H)Hialeah, FLEnsures accurate billing of services is rendered and ensures collections of all co-payments, co-insurance amounts, deductibles, and non-covered amounts for both Hospital & Professional prior to procedure by establishing system to track. UHealth-University of Miami Health System, South Florida's only university-based health system, provides leading-edge patient care powered by the ground breaking research and medical education at the Miller School of Medicine.
NewCase Worker 2 University of MiamiCase Worker 2Miami, FLDepartment Specific Functions: Provide maternal child health services that may include: making initial contacts/phone calls, recruitment, and referral of eligible participants; conducting client assessments; developing individualized care plans to address service needs and risk factors; and providing comprehensive care coordination and wraparound services including parenting education, breastfeeding support, tobacco cessation, inter-conception care education, childbirth education, and psychosocial referral services as needed. This direct service position is responsible for providing maternal child health services to clients (pregnant women and infants) participating in the Healthy Start/CIR CONNECT Programs and related special projects.
Personal Injury Case Manager CbPersonal Injury Case ManagerCoral Gables, FloridaYou'll work closely with clients, coordinate medical treatment, and assist your attorney in building strong, organized, and successful cases. As a Legal Case Manager, you’ll be the central point of contact for clients and a key player in moving cases forward.
LPN Case Manager FIRST CARE HOME SERVICES, INC.LPN Case ManagerFort Lauderdale, FLThe LPN Case Manager ensures continuity of care, compliance with physician orders, timely service delivery, and accurate documentation while serving as a liaison between patients, families, caregivers, physicians, and the interdisciplinary care team. Job Summary The Licensed Practical Nurse (LPN) Case Manager is responsible for coordinating and managing patient care under the supervision of a Registered Nurse (RN) and/or Director of Nursing.
RN Field Case Manager Sedgwick Claims Management Services, Inc.RN Field Case ManagerMiami, FLPRIMARY PURPOSE OF THE ROLE: Sedgwick Field Case Managers work face to face with their injured workers and medical providers to facilitate; though advocacy, progressive medical treatment, and timely return-to-work; while acting as a liaison and providing communication between all involved parties. Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines.
LTSS Service Coordinator - Case Manager (Region I: Miami-Dade/Monroe County) Elevance HealthLTSS Service Coordinator - Case Manager (Region I: Miami-Dade/Monroe County)Miami, FloridaIn collaboration with the person supported, facilitates the Person Centered Planning process that documents the member's preferences, needs and self-identified goals, including but not limited to conducting assessments, development of a comprehensive Person Centered Support Plan (PCSP) and backup plan, interfacing with Medical Directors and participating in interdisciplinary care rounds to support development of a fully integrated care plan, engaging the member's circle of support and overall management of the individuals physical health (PH)/behavioral health (BH)/LTSS needs, as required by applicable state law and co Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
Oncology Prior Authorization Case Manager, Non-Rn - Remote University of MiamiOncology Prior Authorization Case Manager, Non-Rn - RemoteMiami, FLRemoteIdentifies potential delays in treatment or inappropriate utilization by reviewing the treatment plan, serves as a resource to provide education regarding payer policies and assists with coordination of alternative treatment options. UHealth-University of Miami Health System, South Florida's only university-based health system, provides leading-edge patient care powered by the ground breaking research and medical education at the Miller School of Medicine.
AD, Business Case Development-1 SandozAD, Business Case Development-1Princeton, FloridaAbility To Influence Key Stakeholders, Building Effective Teams, Capital Allocation, Compliance And Controls, Critical Thinking, Data Cleansing Normalization, Data Visualization, E2E Process View, Embracing Change, Financial Accounting, Financial And Management Reporting, Giving And Receiving Feedback, Interpersonal Savvy, Market Understanding, Mergers and Acquisitions (M&A), Pmi (Post-Merger Integration), Rapid Problem Solving, Resilience, Tax, Treasury, Understanding Value Drivers Planning & Analysis The Associate Director, Account Strategy & Planning (Business Case Development) is responsible for leading strategic pricing, contracting, and financial analyses that support market access and customer-facing decisions across payers, health systems, group purchasing organizations, specialty pharmacies, wholesalers, and other key customers.
Supervisor, MMA Care Management Independent Living Systems LLCSupervisor, MMA Care ManagementMiami, FLAbout the Role: The Supervisor, MMA Care Management plays a vital role in supervising a care management team that supports members enrolled in the Managed Medical Assistant (MMA) Program that qualify to receive care management services. Key responsibilities include monitoring team performance, reviewing and evaluating work quality, conducting quality assurance activities, and taking corrective action as needed to promote enrollee satisfaction and high-quality service delivery.
Utilization Management Clinician PacificSource Health PlansUtilization Management ClinicianFL$70,950–$106,424.99 / yearEducation, Certificates, Licenses: Active, unrestricted Registered Nurse (RN) license, Licensed Professional Counselor (LPC), Licensed Marriage and Family Therapist (LMFT), Licensed Clinical Social Worker (LCSW), or Psychiatric Mental Health Nurse Practitioner, (PMHNP) credential required. Identify cases that require discharge planning, including transfer to skilled nursing facilities, rehabilitation centers, residential, and outpatient to include behavioral health, home health, and hospice services while considering member co-morbid conditions.
Utilization Management Clinician (Tuesday - Saturday) PacificSource Health PlansUtilization Management Clinician (Tuesday - Saturday)FL$70,950–$106,424.99 / yearEducation, Certificates, Licenses: Active, unrestricted Registered Nurse (RN) license, Licensed Professional Counselor (LPC), Licensed Marriage and Family Therapist (LMFT), Licensed Clinical Social Worker (LCSW), or Psychiatric Mental Health Nurse Practitioner, (PMHNP) credential required. Identify cases that require discharge planning, including transfer to skilled nursing facilities, rehabilitation centers, residential, and outpatient to include behavioral health, home health, and hospice services while considering member co-morbid conditions.
Director of Disability Underwriting - Large Case Unit Massachusetts Mutual Life Insurance CompanyDirector of Disability Underwriting - Large Case UnitMiami, FLRemote$144,800–$190,000 / yearLead the Disability Large Case Unit underwriting team, providing efficient, proactive and exceptional service experience to our field offices and advisors, while ensuring staffing and variable capacity meet growing demands. To ensure we are best positioned to do so, the Disability Underwriting Large Case Unit is guided by the following principles: Cultivate a culture centered on risk discipline, accountability, collaboration and knowledge sharing.
🚨 Red Alert –Rn/Lpn- Urgent Pediatric Case – Miami-Dade, Fl 🚨 Family First Homecare🚨 Red Alert –Rn/Lpn- Urgent Pediatric Case – Miami-Dade, Fl 🚨Miami, Florida$8–$12 / hourFamily First Homecare | 1:1 In-Home Care | Competitive Pay | 8–12 hr shifts | Days/Nights/Weekends | Miami-Dade Family First Homecare is building a strong bench of home health nurses (RN/LPN) for current and upcoming 1:1 in-home cases across Miami-Dade —serving both adult and pediatric patients . If you’re confident with TPN, trach care, and/or vent skills , we’d love to connect and match you to the right case based on your experience and availability.
NewLegal Case Manager CVS Health CorpLegal Case ManagerFL$18.50–$38.82 / hourThe role ensures compliance with HIPAA, applicable state privacy laws, regulatory requirements, and organizational policies by determining whether requests for access to, use of, or disclosure of PHI are legally permissible and properly authorized prior to the release of records. Responsibilities include supporting member rights requests, legal access requests, subpoenas, court orders, regulatory inquiries, law enforcement demands, and other authorized disclosures of health information.
Quality Management Nurse Consultant CVS Health CorpQuality Management Nurse ConsultantFL$60,522–$129,615 / yearContributes to the development, revision, and implementation of policies, procedures, and guidelines that focus on system performance, network provider and community partner performance, and addressing barriers including health disparity and health related social needs, to improve clinical quality, promote best member and provider experience, and ensure patient safety. Collaborates with all POSC stakeholders and participants to ensure cross-functional collaboration, education and participation in establishing, measuring and evaluating best practice interventions aimed to achieve Quality performance goals.
Director of Utilization Management Palm Medical CentersDirector of Utilization ManagementCoral Gables, FLThe Director of Utilization Management will work closely with healthcare providers, staff, and senior leadership to improve patient care, streamline referral processes, and manage care coordination across the organization. Experience: Minimum of 10 years of progressive experience in healthcare administration, with at least 5 years in a leadership role in utilization management, case management, or a related field.